- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $520.91 / $4,301.18 / $9,816.60
| Facility | | $520.91 | $4,301.18 | $9,816.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $471.98 / $552.84 / $1,593.00
| Professional | | $471.98 | $552.84 | $1,593.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $910.49 / $910.49 / $910.49
| Professional | | $910.49 | $910.49 | $910.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,794.89 / $1,794.89 / $1,821.08
| Facility | | $1,794.89 | $1,794.89 | $1,821.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $471.68 / $684.68 / $1,396.49
| Professional | | $471.68 | $684.68 | $1,396.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $530.04 / $530.04 / $2,062.80
| Facility | | $530.04 | $530.04 | $2,062.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $444.53 / $677.72 / $1,330.46
| Professional | | $444.53 | $677.72 | $1,330.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $520.91 / $607.49 / $958.64
| Facility | | $520.91 | $607.49 | $958.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $507.00 / $659.00 / $684.00
| Professional | | $507.00 | $659.00 | $684.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.00 / $693.70 / $1,400.10
| Professional | | $5.00 | $693.70 | $1,400.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,661.00 / $7,659.00 / $10,502.00
| Facility | | $1,661.00 | $7,659.00 | $10,502.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $423.31 / $593.96 / $1,431.75
| Professional | | $423.31 | $593.96 | $1,431.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,973.18 / $6,817.20 / $16,394.00
| Facility | | $2,973.18 | $6,817.20 | $16,394.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,836.80 / $3,836.80 / $4,549.72
| Professional | | $3,836.80 | $3,836.80 | $4,549.72 |